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    A Possible Surgical Option for Patients with Irreparable Rotator Cuff Tears

    The arthroscopic superior capsular reconstruction (SCR) surgical technique can offer patients with irreparable rotator cuff repairs the opportunity to return to sports and jobs that require heavy physical work, according to research presented at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in Toronto, Ontario, Canada.

    Arthroscopic superior capsular reconstruction – developed by lead study author Teruhis Mihata MD, PhD, and his colleagues from Osaka Medical College in Japan – is intended to restore shoulder stability and muscle balance in patients with irreparable rotator cuff tears, which improves deltoid muscle function and relieves pain.

    For this study, Dr. Mihata and colleagues evaluated outcomes in 100 patients (102 shoulders) who failed conservative treatment for irreparable rotator cuff tears and then underwent SCR between 2007 and 2014.

    The researchers focused on shoulder range of motion (ROM) before and after surgery, assessing shoulders before surgery; at 3-, 6-, and 12- months; and then yearly using the American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) shoulder scoring systems.

    On a 100-point scale, average preoperative patient scores were 35.7 points for the ASES scoring system and 52.8 for the JOA scoring system. At final follow-up, scores averaged 92.4 and 91.4 points, respectively.

    Overall, shoulder active range of motion improved by 55.5° for elevation, by 15.4° for external rotation, and by 3 vertebral bodies for internal rotation in patients who underwent SCR.

    The study group included 26 recreational athletes and 34 patients who were still working, including manual laborers. After surgery, all 26 athletes returned to their sports, while 32 of 34 patients returned to their jobs full time. The other 2 working patients reduced their hours and workload.

    “Our research shows promise that this surgical option can offer restored shoulder function for patients who enjoy sports and do heavy physical work after other treatment options have been unsuccessful,” Dr. Mihata said.

    Source

    Mihata T, Lee TQ, Fukunishi K, Fujisawa Y, Kawakami T, Itami Y, Ohue M, Neo M. Return to Sports and Work after Arthroscopic Superior Capsule Reconstruction in Patients with Irreparable Rotator Cuff Tears (paper 165). Presented at the Annual Meeting of the American Orthopaedic Society for Sports Medicine, July 20-23, 2017, Toronto, Ontario, Canada. All abstracts from the meeting can be found here.